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The British Journal of Ophthalmology Dec 2023To compare and rank the myopia control effects of different light wavelengths in children using a systematic review and Bayesian network meta-analysis (Bayesian NMA).
AIMS
To compare and rank the myopia control effects of different light wavelengths in children using a systematic review and Bayesian network meta-analysis (Bayesian NMA).
METHODS
The review protocol was registered with PROSPERO. We searched PubMed, EMBASE and MEDLINE for relevant clinical and animal studies published as of 2 February 2023. We included studies comparing red, violet or full-spectrum light with controls. Data extracted included descriptive statistics and study outcomes (axial length (AL) elongation and progression of spherical equivalent (SE) refraction). After quality assessment, estimates of treatment effect outcomes (mean differences (MDs) and 95% CIs) were first pooled for the animal and clinical studies in a traditional meta-analysis. To compare and rank the different light wavelengths, the Bayesian NMA was then conducted for all the included clinical studies (12 studies) and separately for only randomised controlled trials (8 studies). MDs, 95% credible intervals (CrIs) and ranks of the various light wavelengths were estimated in the Bayesian NMA.
RESULTS
When all clinical studies were included in the Bayesian NMA (12 studies), only red-light significantly slowed AL elongation, MD (95% CrI), -0.38 mm (-0.59 mm to -0.16 mm)/year and SE refraction progression, 0.72D (0.35D to 1.10D)/year compared with controls. It remained the only significant intervention when effect sizes from only RCTs (eight studies) were separately combined, (-0.28 mm (-0.40 mm to -0.15 mm)/year and 0.57D (0.22D to 0.92D)/year, for AL and SE refraction, respectively).
CONCLUSION
Myopia control efficacy varied among different wavelengths of light, with red light ranked as the most effective.
PROSPERO REGISTRATION NUMBER
Clinical studies: CRD42022368998; animal studies: CRD42022368671.
PubMed: 38164527
DOI: 10.1136/bjo-2023-323798 -
The Journal of Sports Medicine and... May 2019Cutting-edge technologies and the rapid urbanization have led to several advantages for mankind and society. However such benefits have been accompanied with the...
INTRODUCTION
Cutting-edge technologies and the rapid urbanization have led to several advantages for mankind and society. However such benefits have been accompanied with the alarming diffusion of sedentary lifestyle disorders, metabolic diseases, major depression and socialization problems, affecting global economy dramatically. The pandemic expansion of chronic diseases is associated with physical inactivity. During the last decade, numerous cities and organizations worldwide have started to adopt strategies aimed at improving outdoor physical activity levels in city residents.
EVIDENCE ACQUISITION
A systematic review focusing on the effects of regular outdoor sports and physical activities across all ages was conducted through multiple databases, according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) standards.
EVIDENCE SYNTHESIS
Performing outdoor sports and physical activities may bear social, psychological and physiological benefits. Preventive effects are similarly documented in youth and seniors towards several morbid conditions: vitamin D deficiency, multiple sclerosis, osteoporosis and myopia.
CONCLUSIONS
Giving the beneficial effects of outdoor sports and physical activities, promotion strategies should be strongly advocated and developed nationally and globally. Likewise, dedicated research areas should inspire guidelines for the promotion of various outdoor activities - a good practice for the social scenario and the healthcare system.
Topics: Chronic Disease; Exercise; Health Promotion; Humans; Sedentary Behavior; Sports
PubMed: 30650943
DOI: 10.23736/S0022-4707.18.08771-6 -
Seminars in Ophthalmology Aug 2023To evaluate myopia progression during the novel coronavirus disease 2019 (COVID-19) pandemic and its risk factors. (Meta-Analysis)
Meta-Analysis
BACKGROUND
To evaluate myopia progression during the novel coronavirus disease 2019 (COVID-19) pandemic and its risk factors.
METHODS
We searched PubMed, Scopus, and Web of Science to find literature until August 2022 related to COVID-19 pandemic and myopia progression. Outcomes of myopia progression included axial length (AL) and spherical equivalent (SE). Factors of screen time and outdoor activity time were analyzed.
RESULTS
Thirty-three studies were included in this meta-analysis. Compared to the same period before the COVID-19 pandemic, myopia prevalence increased (OR = 1.11; 95% CI, 1.05-1.18). The outcomes of SE decreased -0.61 diopter (95% CI, -0.98 to -0.23), and AL increased 0.42 mm (95% CI, 0.13-0.7). Mean screen time was increased 6.25 hours/day (95% CI, 4.84-7.66), and outdoor activity time was decreased -1.52 hours/day (95% CI, -3.20 to -0.15).
CONCLUSION
Establishing care policies is necessary to restrict behavioral changes and their consequences during the pandemic.
Topics: Humans; Pandemics; COVID-19; Myopia; Refraction, Ocular; Risk Factors; Disease Progression
PubMed: 36734046
DOI: 10.1080/08820538.2023.2168490 -
Clinical & Experimental Ophthalmology 2023We performed a systematic review and meta-analysis to investigate the links between different sleep characteristics and risk of myopia.
BACKGROUND
We performed a systematic review and meta-analysis to investigate the links between different sleep characteristics and risk of myopia.
METHODS
PubMed, EMBASE, Web of Science, the Cochrane Library, PsycINFO, Wanfang, and CNKI were searched from inception to August 26, 2022, without any language restriction. Cross-sectional, case-control, or cohort studies that explored the association between sleep duration, sleep quality, bedtime, and myopia were included. NIH quality assessment tools were used to assess the methodological quality of included studies. Random-effect or fixed-effect models were used to pool the associations according to whether there is heterogeneity.
RESULTS
A total of 31 studies with 205 907 participants were included in the final analysis (25 studies reporting sleep duration; four studies examining sleep quality and six studies evaluating bedtime). Compared to reference sleep duration, sufficient sleep duration (OR = 0.63, 95% CI = 0.51-0.78) was associated with a lower risk of myopia, and short sleep duration (OR = 1.66, 95% CI = 1.14-2.42) was associated with a higher risk of myopia. In addition, poor sleep quality (OR = 1.24, 95% CI = 1.05-1.47) was associated with a higher risk of myopia while late bedtime (OR = 1.30, 95% CI = 0.96-1.75) was not significantly associated with an increased risk of myopia.
CONCLUSIONS
Alteration in sleep duration and sleep quality may influence the risk of myopia. Well-designed cohort studies are needed in future investigations to identify a causal relationship between different sleep characteristics and myopia.
PubMed: 37468126
DOI: 10.1111/ceo.14277 -
Survey of Ophthalmology 2023The toxicology of secondhand smoke (SHS), along with the harm of its exposure to human health, has been generally acknowledged; however, specific evidence is lacking on... (Review)
Review
The toxicology of secondhand smoke (SHS), along with the harm of its exposure to human health, has been generally acknowledged; however, specific evidence is lacking on the association between SHS exposure and ocular health. In this systematic review (PROSPERO registration number: CRD42022247992), we included 55 original articles published by 12 May 2023, which dealt with SHS exposure and ocular disorders, such as eye irritation, conjunctivitis, dry eye diseases, uveitis, myopia, astigmatism, contact lens discomfort, age-related macular degeneration, glaucoma, and thyroid eye disease that addressed the ocular neurovascular structures of the macular, retinal nerve fiber layer, choroid, and corneal biomechanical parameters. We found compelling correlational evidence for eye irritation, conjunctivitis, and dry eye symptoms-supporting that SHS exposure was positively associated with inflammatory and allergic changes in the eyes. Yet, evidence about the associations between SHS exposure and other ocular disorders, structures, and parameters is still limited or controversial. Given the limitations of existing literature, more investigations with high quality and rigorous design are warranted to elucidate the potentially harmful effects of SHS exposure on ocular health.
Topics: Humans; Tobacco Smoke Pollution; Eye; Macular Degeneration; Conjunctivitis
PubMed: 37479063
DOI: 10.1016/j.survophthal.2023.07.001 -
Systematic Review of Myopia Progression after Cessation of Optical Interventions for Myopia Control.Journal of Clinical Medicine Dec 2023Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This... (Review)
Review
Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms.
PubMed: 38202060
DOI: 10.3390/jcm13010053 -
Ophthalmology and Therapy Dec 2023This study aims to assess the existing literature on fundus tessellation (FT), focusing on its prevalence, associated factors, distribution, and progression.
INTRODUCTION
This study aims to assess the existing literature on fundus tessellation (FT), focusing on its prevalence, associated factors, distribution, and progression.
METHODS
Systemic methods were employed to search and gather published literature on FT from databases such as the National Library of Medicine (PubMed), Web of Science (WOS), and Elsevier on July 1, 2023. The quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS) and the Healthcare Research and Quality (AHRQ) criteria. A meta-analysis was conducted to compare tessellated and normal fundus with respect to age, gender, axial length, and spherical equivalent.
RESULTS
The systematic review included 23 articles, encompassing a total of 3053 eyes in the meta-analysis. The prevalence of FT varied from 43.00 to 94.35%. The severity of FT was significantly associated with older age, male sex, lower body weight index, longer axial length, larger peripapillary atrophy, thinner choroid, thinner sclera, and larger corneal radius of curvature, suggesting a potential progression pattern. Notably, FT was observed predominantly in the macular and peripapillary regions. The meta-analysis revealed that tessellated fundus tended to be associated with older age (mean difference [MD] 4.76, 95% confidence interval [CI] 1.71-7.80, P < 0.01), longer axial length (MD 0.86, 95% CI 0.70-1.02, P < 0.01), and a lower spherical equivalent (MD - 1.16, 95% CI - 1.68 to 0.65, P < 0.01) compared to normal fundus. However, there was no significant difference in the proportion of males between individuals with tessellated and normal fundus (odds ratio [OR] 1.12, 95% CI 0.89-1.42, P = 0.32).
CONCLUSIONS
Overall, this systematic review and meta-analysis shed light on the prevalence, characteristics, and factors associated with FT, offering valuable insights for clinicians and researchers in the field of ophthalmology.
STUDY REGISTRATION
The study protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023442486).
PubMed: 37733224
DOI: 10.1007/s40123-023-00802-0 -
American Journal of Ophthalmology Jun 2017To compare the postoperative efficacy, predictability, safety, and visual quality of all major forms of laser corneal refractive surgeries for correcting myopia. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To compare the postoperative efficacy, predictability, safety, and visual quality of all major forms of laser corneal refractive surgeries for correcting myopia.
DESIGN
Systematic review and network meta-analysis.
METHODS
Search of MEDLINE, EMBASE, Cochrane Library, and the US trial registry was conducted up to November 2015. Randomized controlled trials (RCT) reporting in accordance with the eligibility criteria were included in this review. We performed a Bayesian random-effects network meta-analysis.
RESULTS
Forty-eight RCTs were identified. For efficacy (uncorrected visual acuity [UCVA]), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA (surface under the cumulative ranking curve) ranking (from best to worst) was femtosecond-based laser in situ keratomileusis (FS-LASIK), LASIK, small-incision lenticule extraction, femtosecond lenticule extraction (FLEx), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), epipolis (Epi)-LASIK, transepithelial PRK (T-PRK). For predictability (refractive spherical equivalent [SE]), a statistically significant difference was found when FS-LASIK was compared with LASIK (odds ratio [OR] 2.29, 95% credible interval [CrI] 1.20-4.14), PRK (OR 2.16, 95% CrI 1.15-4.03), LASEK (OR 2.09, 95% CrI 1.08-4.55), and Epi-LASIK (OR 2.74, 95% CrI 1.11-6.20). The SUCRA ranking (from best to worst) was FS-LASIK, T-PRK, LASEK, PRK, LASIK, Epi-LASIK. There were no statistically significant differences in the safety (best spectacle-corrected visual acuity) comparisons. For both postoperative higher-order aberrations (HOAs) and contrast sensitivity (CS), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA ranking results show that some corneal surface ablation techniques (PRK and LASEK) rank highest.
CONCLUSIONS
This network meta-analysis shows that there were no statistically significant differences in either visual outcomes (efficacy and safety) or visual quality (HOAs and CS). FS-LASIK behaved better in predictability than any other type of surgeries.
Topics: Cornea; Humans; Lasers, Excimer; Myopia; Network Meta-Analysis; Photorefractive Keratectomy; Postoperative Period; Refraction, Ocular; Visual Acuity
PubMed: 28336402
DOI: 10.1016/j.ajo.2017.03.013 -
Environmental Pollution (Barking, Essex... Dec 2022An increasing body of evidence has linked greenspace and various health outcomes in children and adolescents, but the conclusions were inconsistent. For this review, we... (Meta-Analysis)
Meta-Analysis Review
An increasing body of evidence has linked greenspace and various health outcomes in children and adolescents, but the conclusions were inconsistent. For this review, we comprehensively summarized the measurement methods of greenspace, resultant health outcomes, and potential mechanisms from epidemiological studies in children and adolescents (aged ≤19 years). We searched for studies published and indexed in MEDLINE and EMBASE (via Ovid) up to April 11, 2022. There were a total of 9,291 studies identified with 140 articles from 28 countries finally assessed and included in this systematic review. Over 70% of the studies were conducted in highly urbanised countries/regions, but very limited research has been done in low-and middle-income countries and none in Africa. Measures of greenspace varied. Various health outcomes were reported, including protective effects of greenspace exposure on aspects of obesity/overweight, myopia, lung health, circulatory health, cognitive function, and general health in children and adolescents. The associations between greenspace exposure and other health outcomes were inconsistent, especially for respiratory health studies. We pooled odds ratios (OR) using random-effects meta-analysis for health outcomes of asthma (OR = 0.94, 95%CI: 0.84 to 1.06), allergic rhinitis (OR = 0.95; 95% CI: 0.73 to 1.25), and obesity/overweight (OR = 0.91, 95%CI: 0.84 to 0.98) with per 0.1 unit increase in normalized difference in vegetation index (NDVI). These associations have important implications for the assessment and management of urban environment and health in children and adolescents.
Topics: Child; Humans; Adolescent; Overweight; Parks, Recreational; Obesity; Asthma; Outcome Assessment, Health Care
PubMed: 36122655
DOI: 10.1016/j.envpol.2022.120193 -
Asia-Pacific Journal of Ophthalmology... Sep 2022To conduct a systematic review and meta-analysis to assess the effects of coronavirus disease 2019 (COVID-19) pandemic-related lifestyle on myopia outcomes in children... (Meta-Analysis)
Meta-Analysis
PURPOSE
To conduct a systematic review and meta-analysis to assess the effects of coronavirus disease 2019 (COVID-19) pandemic-related lifestyle on myopia outcomes in children to young adults.
METHODS
A systematic search was conducted on PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases (with manual searching of reference lists of reviews). Studies included assessed changes in myopia-related outcomes (cycloplegic refraction) during COVID and pre-COVID. Of 367 articles identified, 7 (6 prospective cohorts; 1 repeated cross-sectional study) comprising 6327 participants aged 6 to 17 were included. Quality appraisals were performed with Joanna Briggs Institute Critical Appraisal Checklists. Pooled differences in annualized myopic shifts or mean spherical equivalent (SE) during COVID and pre-COVID were obtained from random-effects models.
RESULTS
In all 7 studies, SE moved toward a myopic direction during COVID (vs pre-COVID), where 5 reported significantly faster myopic shifts [difference in means of changes: -1.20 to -0.35 diopters per year, [D/y]; pooled estimate: -0.73 D/y; 95% confidence interval (CI): -0.96, -0.50; P<0.001], and 2 reported significantly more myopic SE (difference in means: -0.72 to -0.44 D/y; pooled estimate: -0.54 D/y; 95% CI: -0.80, -0.28; P<0.001). Three studies reported higher myopia (SE ≤-0.50 D) incidence (2.0- to 2.6-fold increase) during COVID versus pre-COVID. Of studies assessing lifestyle changes, all 4 reported lower time outdoors (pre-COVID vs during COVID: 1.1-1.8 vs 0.4-1.0 hours per day, [h/d]), and 3 reported higher screen time (pre-COVID vs during COVID: 0.7-2.8 vs 2.4-6.9 h/d).
CONCLUSIONS
This review suggests more myopic SE shifts during COVID (vs pre-COVID) in participants aged 6 to 17. COVID-19 restrictions may have worsened SE shifts, and lifting of restrictions may lessen this effect. Evaluations of the long-term effects of the pandemic lifestyle on myopia onset and progression in large studies are warranted to confirm these findings.
Topics: COVID-19; Child; Cross-Sectional Studies; Disease Progression; Humans; Life Style; Mydriatics; Myopia; Pandemics; Prospective Studies; Refraction, Ocular; Young Adult
PubMed: 36179338
DOI: 10.1097/APO.0000000000000559